Prognosis and related factors in elderly patients with diabetes mellitus complicated with COVID-19

doi:10.3877/cma.j.issn.1674-6902.2022.01.008

Abstract

Abstract:

Objective

To invistigate the clinical characteristics and related mortality factors of elderly patients with diabetes mellitus complicated with COVID-19, and to provide reference for the early prevention and treatment of such patients.

Methods

A total of 3733 COVID-19 patients confirmed in Hospital, and 227 elderly patients with diabetes were included as the analysis subjects. From medical records extracted general information, basic diseases, clinical characteristics, laboratory results and death of patients and then descripte and analysis through SPSS 23.0.

Results

227 elderly patients with diabetes mellitus complicated with COVID-19. Sixteen elderly patients with COVID-19 complicated with diabetes died during hospitalization, with a fatality rate of 7.0% (16/227). Univariate and multivariate logistic regression analysis showed that pulmonary disease, leukocyte, blood sugar, Neutrophils, creatinin, CKMB and dyspnea were correlation factors of prognosis in elderly patients with diabetes complicated with COVID-19; The area under ROC curve for predicting death in elderly patients with diabetes combined with COVID-19 by these factors was 96.0%(95CI: 91.0%-100.0%).

Conclusion

Among the elderly patients, the risk of prognosis with diabetes complicated with COVID-19 is higher, and it possesses higher degree of accuracy to predict the risk of prognosis within these patients by using related factors such as blood sugar and leukocyte.

Key words: Corona virus disease 19(COVID-19), Diabetes mellitus, Related factors, Prognosis

Dan Qian, Jialin He, Hao Lin, Qimi Huang, Weijia Liu, Guoche Zhao, Xi Liu, Mengyuan Gao, Xintao Pan, Chengshan Ren. Prognosis and related factors in elderly patients with diabetes mellitus complicated with COVID-19[J]. Chinese Journal of Lung Diseases(Electronic Edition), 2022, 15(01): 33-37.

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References 30

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临床资料		合计(n＝227)	存活(n＝211)	死亡(n＝16)	χ²/t值	P值
男/女		126/101	114/97	12/4	-	0.123
年龄[median(P₂₅~P₇₅)]		69(65~75)	69(65~74)	77.5(68~82.5)	2.166	0.030
体温(Mean±SD)		37. 66±1.03	37.63±1.02	38.14±1.10	1.804	0.089
发热		155(68.28)	143(67.77)	12(75.00)	0.359	0.549
呼吸频率(次/min)		20(19~22)	20(19~22)	22(20~24)	2.907	0.004
脉搏(次/min)		85(78~95)	85(78~94)	93.5(81~111.75)	2.105	0.035
首发症状持续时间(h)		20(12~30)	20(13~30)	13(10~28.25)	1.365	0.172
临床症状
	咳嗽	158(69.6)	144(68.25)	14(87.5)	2.606	0.106
	咳痰	30(13.22)	28(13.27)	2(12.5)	-	1.000
	呼吸困难	74(32.6)	62(29.38)	12(75)	14.085	0.000
	胸闷	47(20.7)	43(20.38)	4(25)	-	0.748
	腹泻	9(3.96)	9(4.27)	0	-	-
	食欲减退	73(32.16)	67(31.75)	6(37.5)	0.225	0.635
既往疾病史
	高血压史	136(59.91)	128(60.66)	8(50.00)	0.704	0.401
	冠心病史	29(12.78)	24(11.37)	5(31.25)	5.272	0.022
	肺部疾病史	11(4.85)	8(3.79)	3(18.75)	-	0.034
	空腹血糖(mmol/L)	10.59±3.98	9.89±4.12	13.26±3.89	3.165	0.002
WBC(>10×10⁹/L)		19(8.37)	12(5.69)	7(43.75)	28.094	0.000
中性粒细胞(>75%)		47(20.7)	37(17.54)	10(62.5)	18.315	0.000
胆红素(>26 μmol/L)		8(3.52)	4(1.90)	4(25.00)	-	0.001
ALT(>50 IU/L)		27(11.89)	22(10.43)	5(31.25)	6.154	0.013
AST(>40 IU/L)		7(3.08)	4(1.90)	3(18.75)	14.136	0.000
白蛋白(<35 g/L)		39(17.18)	36(17.06)	3(18.75)	-	0.742
CRP(>4.0 mg/L)		131(57.71)	118(55.92)	13(81.25)	-	0.065
肌酐(>111 μmol/L)		18(7.93)	13(6.16)	5(31.25)	12.822	0.000
CKMB(>24 IU/L)		29(12.78)	21(9.95)	8(50)	21.405	0.000
重症患者		86(37.89)	73(34.6)	13(81.25)	13.755	0.000

临床资料		合计(n＝227)	存活(n＝211)	死亡(n＝16)	χ²/t值	P值
男/女		126/101	114/97	12/4	-	0.123
年龄[median(P₂₅~P₇₅)]		69(65~75)	69(65~74)	77.5(68~82.5)	2.166	0.030
体温(Mean±SD)		37. 66±1.03	37.63±1.02	38.14±1.10	1.804	0.089
发热		155(68.28)	143(67.77)	12(75.00)	0.359	0.549
呼吸频率(次/min)		20(19~22)	20(19~22)	22(20~24)	2.907	0.004
脉搏(次/min)		85(78~95)	85(78~94)	93.5(81~111.75)	2.105	0.035
首发症状持续时间(h)		20(12~30)	20(13~30)	13(10~28.25)	1.365	0.172
临床症状
	咳嗽	158(69.6)	144(68.25)	14(87.5)	2.606	0.106
	咳痰	30(13.22)	28(13.27)	2(12.5)	-	1.000
	呼吸困难	74(32.6)	62(29.38)	12(75)	14.085	0.000
	胸闷	47(20.7)	43(20.38)	4(25)	-	0.748
	腹泻	9(3.96)	9(4.27)	0	-	-
	食欲减退	73(32.16)	67(31.75)	6(37.5)	0.225	0.635
既往疾病史
	高血压史	136(59.91)	128(60.66)	8(50.00)	0.704	0.401
	冠心病史	29(12.78)	24(11.37)	5(31.25)	5.272	0.022
	肺部疾病史	11(4.85)	8(3.79)	3(18.75)	-	0.034
	空腹血糖(mmol/L)	10.59±3.98	9.89±4.12	13.26±3.89	3.165	0.002
WBC(>10×10⁹/L)		19(8.37)	12(5.69)	7(43.75)	28.094	0.000
中性粒细胞(>75%)		47(20.7)	37(17.54)	10(62.5)	18.315	0.000
胆红素(>26 μmol/L)		8(3.52)	4(1.90)	4(25.00)	-	0.001
ALT(>50 IU/L)		27(11.89)	22(10.43)	5(31.25)	6.154	0.013
AST(>40 IU/L)		7(3.08)	4(1.90)	3(18.75)	14.136	0.000
白蛋白(<35 g/L)		39(17.18)	36(17.06)	3(18.75)	-	0.742
CRP(>4.0 mg/L)		131(57.71)	118(55.92)	13(81.25)	-	0.065
肌酐(>111 μmol/L)		18(7.93)	13(6.16)	5(31.25)	12.822	0.000
CKMB(>24 IU/L)		29(12.78)	21(9.95)	8(50)	21.405	0.000
重症患者		86(37.89)	73(34.6)	13(81.25)	13.755	0.000

临床资料	变　量	B	SE	Wald	P值	OR	OR 95%CI
临床资料	变　量	B	SE	Wald	P值	OR	下限	上限
肺部疾病^a	无					1
	有	3.119	1.273	6.003	0.014	22.62	1.87	274.20
WBC	正常						1
	升高	4.277	1.127	14.399	0.000	72.02	7.91	655.87
中性粒细胞	正常					1
	升高	2.512	0.940	7.142	0.008	12.33	1.95	77.83
肌酐	正常					1
	升高	2.872	1.104	6.767	0.009	17.67	2.03	153.81
CKMB	正常					1
	升高	4.293	1.145	14.069	0.000	73.19	7.77	689.72
呼吸困难	无					1
	有	2.347	0.942	6.209	0.013	10.46	1.65	66.27
常量		-8.336	1.619	26.495	0.000	0.000

临床资料	变　量	B	SE	Wald	P值	OR	OR 95%CI
临床资料	变　量	B	SE	Wald	P值	OR	下限	上限
肺部疾病^a	无					1
	有	3.119	1.273	6.003	0.014	22.62	1.87	274.20
WBC	正常						1
	升高	4.277	1.127	14.399	0.000	72.02	7.91	655.87
中性粒细胞	正常					1
	升高	2.512	0.940	7.142	0.008	12.33	1.95	77.83
肌酐	正常					1
	升高	2.872	1.104	6.767	0.009	17.67	2.03	153.81
CKMB	正常					1
	升高	4.293	1.145	14.069	0.000	73.19	7.77	689.72
呼吸困难	无					1
	有	2.347	0.942	6.209	0.013	10.46	1.65	66.27
常量		-8.336	1.619	26.495	0.000	0.000

变　量	AUC	标准误	P值	AUC 95%CI
变　量	AUC	标准误	P值	下限	上限
方程预测值	0.960	0.025	0.000	0.910	1.000
有无呼吸困难	0.731	0.065	0.002	0.603	0.859
有无肺部疾病	0.577	0.082	0.305	0.417	0.737
WBC升高	0.690	0.082	0.011	0.530	0.850
中性粒细胞升高	0.673	0.070	0.021	0.536	0.810
肌酐升高	0.625	0.082	0.096	0.464	0.786
CKMB升高	0.707	0.079	0.006	0.551	0.862

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